Comparative Analysis of Mean Platelet Volume and Immature Platelet Fraction in Acute Ischemic Stroke Patients: A...

Platelets play a pivotal role in the pathogenesis of thrombotic vascular events such as acute ischemic stroke (AIS). Mean platelet volume (MPV) and immature platelet fraction (IPF) are emerging biomarkers of platelet activity and turnover. This study aimed to investigate the diagnostic significance of MPV and IPF in AIS and to explore their relationship with comorbidities such as diabetes mellitus (DM) and hypertension (HTN).

In a cross-sectional design, 175 patients with first-ever AIS and 175 age- and sex-matched controls were evaluated. MPV and IPF values were obtained from automated hematology analyzers. Statistical analyses were performed using SPSS version 26, employing independent t -tests, Chi-square tests, and receiver operating characteristic (ROC) curve analyses.

AIS patients exhibited significantly elevated MPV (9.60 ± 1.03 fL vs. 5.37 ± 1.09 fL, P < 0.001) and IPF (4.96% ± 2.44% vs. 2.95% ± 1.40%, P < 0.001) compared to controls. ROC analysis revealed MPV had an area under the curve (AUC) of 0.821, and IPF had an AUC of 0.747. Subgroup analysis showed that elevated MPV and IPF were more pronounced in AIS patients with coexisting DM and HTN. MPV showed significant elevation in AIS vs. controls in the DM + HTN subgroup (10.99 ± 1.73 vs. 9.52 ± 0.88 fL, P = 0.050), suggesting synergistic platelet activation in the presence of metabolic comorbidities.

Elevated MPV and IPF are significantly associated with AIS and may serve as accessible, cost-effective diagnostic markers. MPV in particular shows promise as a risk stratifier, especially in patients with DM and HTN. Future longitudinal studies are warranted to evaluate their prognostic potential.